Provider Demographics
NPI:1114172939
Name:FISHER, DAISY VIRGINIA (ANP)
Entity Type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:VIRGINIA
Last Name:FISHER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE STE 1340
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6935
Mailing Address - Country:US
Mailing Address - Phone:301-652-2585
Mailing Address - Fax:301-652-0380
Practice Address - Street 1:5454 WISCONSIN AVE STE 1340
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6935
Practice Address - Country:US
Practice Address - Phone:301-652-2585
Practice Address - Fax:301-652-0380
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR255540363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD88-4034430OtherMARYLAND
MD884034430OtherMARYLAND